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A
study published in the December 15, 2005 issue of the New England
Journal of Medicine shows that women with inactive or stable
lupus might be able to use oral contraceptives containing estrogen
without triggering significant additional disease activity. “The
findings are important because women represent 90 percent of
the estimated 1.5 million cases of lupus in the United States,” said Sandra
C. Raymond, President & CEO of the Lupus Foundation of America
(LFA). “The results are welcome news as
lupus develops most frequently during the childbearing years
and many women with lupus can benefit from the use of oral contraceptives. “
Because
lupus pregnancies are associated with higher risk, oral contraceptives
offer the advantage of a planned pregnancy timed for periods
of remission, improving the chances for a better outcome. Also, a reliable form of birth control
is important for women with lupus who are being treated with
immunosuppressive agents that may harm the fetus. Oral
contraceptives also might improve bone health among women who
are taking steroids for the treatment of lupus and could possibly
preserve ovarian function among those patients who are taking
medications that can contribute to infertility, although sufficient
careful, controlled studies about these potential benefits are
lacking. The
study conducted at 15 centers in the United States involved 183 women ages
18-39 with inactive or stable lupus. Women
who had severe or unstable lupus, high blood pressure, a history
of abnormal blood clotting, or moderate to high levels of antiphospholipid
antibodies (considered a risk for blood clotting) were not eligible
for the study. Half
of the study participants received oral contraceptives (Ortho-Novum
7/7/7) while the other half received a placebo. Researchers
measured the number of severe or mild/moderate flares over a
one-year period. Only seven
of the 91 individuals who received oral contraceptives experienced
a severe flare compared to seven of 92 individuals who received
the placebo. The
rate of mild to moderate flares also was not significantly different
between the two groups. Sixty-three individuals who received
oral contraceptives had mild to moderate flares compared to 55
individuals who received the placebo. In
this study, the researchers found that oral contraceptives
did not increase the risk of flares among women with lupus who
have stable disease.
“This
study provides important information to women with lupus and
their physicians when making informed decisions about the appropriateness
and safety of oral contraceptives,” said Raymond. “It
is hoped that these kinds of studies will help to build a better
quality of life for the 1.5 million Americans with the disease.”
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